Which hormone therapy option did you choose for ER+ breast cancer under 40?

Making endocrine therapy decisions at 39 with hormone-positive breast cancer involves weighing complex factors that can feel overwhelming. Many community members have navigated similar crossroads between ovarian suppression combined with hormone blockers versus tamoxifen alone, and their shared experiences often highlight how personal circumstances, side effect tolerance, and long-term goals all play important roles in the decision-making process. Connecting with others who have similar tumor characteristics and treatment history can provide valuable insights as you work with your medical team to determine the best path forward.

Hey Callie, I’m Marti. Was diagnosed HR+ HER2 neg/low and node+ breast cancer in January 2025. I’m 35 yo and in full blown menopause. I am on verzenio 2x/day, anastrozole 1x/day and monthly zoladex implant. I don’t have a period anymore. I get pretty emotionally dysregulated for a couple days around the zoladex injection. The verzenio took some time to regulate/balance with my digestive system. (Best for me, I take half an Imodium every morning). And I have hot flashes regularly- multiple times a day (they are a little worse around my injection) but I am actively experimenting with nutrition to find an overall physical balance. The recurrence percentages were most encouraging of my decision and then lack of interest in having kids kind of sealed the deal for me to continue with this oral regimen. I did get curious about an oophorectomy instead of the pill/injection combo of ovarian suppression bc of convenience/ duration of side effects but have not moved forward with surgery. Here to answer if you have any more questions or curiosities. Marti

I was diagnosed last year at 38 with stage 1b dcis, er+, her2 negative breast cancer. I had a lumpectomy and full breast radiation. I chose tamoxifen and started it last July. My reasons being … 1) I didn’t want to be put into menopause for five years and then pulled back out.. if I were in my lat 40s I probably would’ve done the ovarian suppression. 2) I don’t have the lifestyle that allows for me to go to the dr and get a pregnancy test and a shot every month(travel for work a lot.) 3. Honestly, cost/unstable health insurance. Tamoxifen cost $238 for a 3 months supply. Sorta sad that that was a factor… but this is America. The worst side effects have been constipation, depression, and brain fog. I haven’t experienced hot flashes and the joint pain is minimal. I also have cut out drinking and changed my diet to help minimize risk.